Prostate Health And Cancer Prevention Tips

Everything You Need To Know About Keeping Your Prostate Healthy

Do you need to urinate frequently, especially at night, with your flow looking more like a drip than a stream?

Are you experiencing changes in urinary or sexual function?

Sorry for sounding like a pharmaceutical commercial, but hopefully this caught your attention.

With Movember here, moustached men around the globe will sport facial hair in support of men’s health.

And one of the biggest afflictions to men around the world is prostate cancer, which affects one in seven men in North America. In 2014, approximately 233,000 men were diagnosed with prostate cancer, and more than 29,000 men will die from the disease. One new case occurs every 2.3 minutes and a man dies from prostate cancer every 18 minutes.The American Cancer Society estimates that about 180,890 new cases of prostate cancer were diagnosed in the U.S. in 2016.

Knowledge is power, though: This guide will help you understand everything you need to know about your prostate as well as ways to reduce your risk of developing the disease.

What Does The Prostate Do?

According to PubMed Health, the prostate is responsible for a few small but important roles, including:

Production of fluid for semen: Together with sperm cells from the testicles and fluids from other glands, semen is born. The muscles of the prostate also press semen into the urethra during ejaculation (sorry for the visual).

The closing of the urethra up to the bladder during ejaculation: During ejaculation, the prostate and the bladder’s sphincter muscle close the urethra up to the bladder to prevent semen from entering the bladder.

The closing of the seminal ducts during urination: During urination, the central zone muscles close the prostate ducts so that urine can’t enter.

Hormone metabolism: In the prostate, the male sex hormone testosterone is transformed to a biologically active form, DHT (dihydrotestosterone).

What Is Prostate Cancer?

Prostate cancer occurs when some of the cells in the prostate reproduce far more rapidly than normal, resulting in a tumor. If left untreated, prostate cancer cells may eventually spread from the prostate and invade distant parts of the body, particularly the lymph nodes and bones, producing secondary tumors in a process known as metastasis.
One of the most worrying aspects of the disease is that most prostate cancers develop without men experiencing any symptoms in the early stages.

Risk Factors

Prostate cancer only affects men, as women do not have a prostate gland. Risk factors for developing the disease include:

Age: The older a man gets, the more likely he is to be diagnosed with prostate cancer.

Family History: A man with a father or brother who developed prostate cancer is twice as likely to develop the disease.

Ethnicity: There’s an increased incidence of the disease in black African and Afro-Caribbean males.

Symptoms, Testing & Treatment

As mentioned, the disease can sneak up on men without any obvious warning signs.

Some men, however, will experience changes in urinary or sexual function that might (keyword: might) indicate the presence of prostate cancer. These symptoms include:

A need to urinate frequently, especially at night

Difficulty starting urination or holding back urine

Weak or interrupted flow of urine

Painful or burning urination

Difficulty in having an erection

Painful ejaculation

Blood in urine or semen

Frequent pain or stiffness in the lower back, hips, or upper thighs

What Is BPH?

Benign prostatic hyperplasia (BPH), a condition in which the prostate gland becomes enlarged, could be a sign of early onset prostate cancer. BPH happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems. It is not cancer, and it does not raise your risk for prostate cancer. Common symptoms of BPH include many of the same warning signs of prostate cancer (which complicates matters), including difficulty in starting urination and a weak urine stream; a sudden urge to urinate; and more frequent urination, especially at night.

Difference between BPH and Prostate Cancer

Prostate cancer begins in the outer peripheral zone of the prostate, and grows outward, invading surrounding tissue. BPH is an enlargement of the gland itself.

Getting Tested For Prostate Cancer

Prostate cancer begins in the outer peripheral zone of the prostate, and grows outward, invading surrounding tissue. BPH is an enlargement of the gland itself.

The Digital Rectal Exam (DRE)

The DRE involves the doctor inserting a gloved finger in the anus, where it is possible to feel part of the surface of the prostate. Yes, it sounds awful, but it works.

Biopsy

Based on your test results, you may be referred to a urologist to have a biopsy taken. This is the only way to determine if cancer is present.

The PSA Blood Test (PSA)

The PSA blood test looks for the presence of a protein in the blood that is produced specifically by prostate cells. The higher the man’s blood PSA levels, the more likely that he has cancer.

This blood test has recently created a media firestorm after Hollywood actor Ben Stiller spoke about the benefits of the test. Stiller’s doctor ordered a baseline PSA test, even though he had no family history of prostate cancer and no obvious symptoms.

“Taking the PSA test saved my life. Literally,” Stiller wrote in an essay on Medium.com. “If I had waited until I was 50, as the American Cancer Society recommends, I would not have known I had a growing tumor until two years after I got treated,” Stiller said. “If I had followed the U.S. Preventive Services Task Force guidelines, I would have never gotten tested at all, and not have known I had cancer until it was way too late to treat successfully.”

His story is in direct conflict with recommendations made in 2012 by the U.S. Preventive Services Task Force — and soon followed by a similar Canadian panel — suggesting the test saves few, if any, extra lives and recommends the test not be conducted on otherwise healthy men until later in life.

Toronto urologist Dr. Laurence Klotz suggests Canadian and American expert panels have got it wrong. Klotz, a world leader in prostate cancer, told the National Post that Stiller’s story conveys the benefits of PSA screening. He said most in the field recommend an initial PSA screen be performed on men in their mid-40s. If the PSA numbers are low, asymptomatic men should be left alone for another five years or so. If higher than normal, which is the case for only about 10 percent of men in their 40s, “that patient needs to be watched more carefully,” Klotz told the National Post.

However, Tim Caulfield, author of Is Gwyneth Paltrow Wrong About Everything? When Celebrity Culture and Science Clash, suggests taking celebrity endorsements with a grain of salt. "The first thing I'd suggest is to not be swayed by anecdote. No matter how compelling the story — and Ben Stiller told a good story — an anecdote is just that, an anecdote,” Caulfield wrote in an email.

“We should base health care decisions on the best available evidence, not on high profile narratives about the value of a screening procedure. Most international guidelines have questioned the value of PSA screening. I hesitate to tell other people how to proceed. But I will say this: I won't be getting it done. (Yep, that's an anecdote!),” added Caulfield.

One person, commenting on the condition of anonymity, said the PSA screening created unnecessary anxiety. “My PSA results were way over the top, [so] I had a biopsy with 5 percent cancer found in one of eight cores with a Gleason score of 6. Within a year, my urologist was advising me to have it removed, but I was hesitant given the white papers from Johns Hopkins University that recommended watchful waiting,” he said in a Facebook post.

“Four years later, a resident working with my doctor had a fit when he saw my PSA levels, so off I went for another biopsy. No cancer found. At 75 [years old], we still monitor my PSA once a year but the Cancer Society and my doc know I'm going to get bizarre results, so if it's under 14, no biopsies. The PSA can be helpful, but in my case, it caused unnecessary anxiety over a number of years.”

How To Reduce Your Risk

According to the Prostate Cancer Foundation, here some general recommendations

Eat fewer calories or exercise more so that you maintain a healthy weight. Men who are obese — a body mass index (BMI) of 30 or higher — may have an increased risk of prostate cancer. The old faithfuls, diet and exercise, are key here.

(Possibly) Try to keep the amount of fat you get from red meat and dairy products to a minimum. In studies, men who ate the most dairy products — such as milk, cheese and yogurt — each day had the highest risk of prostate cancer. But study results have been mixed, and the risk associated with dairy products is thought to be small, so don’t give it up if it’ll add to your stress levels — as that can make things worse (see #7 & 9).

Watch your calcium intake. Do not take supplemental doses far above the recommended daily allowance. Some calcium is OK, but avoid taking more than 1,500 mg of calcium a day.

Eat more fish — such as salmon, tuna and herring — containing omega-3 fatty acids, a type of fatty acid that has been linked to a reduced risk of prostate cancer. If you don't currently eat fish, you might consider adding it to your diet or supplementing with fish oil. Reduce your intake of trans fatty acids (found in margarine).

Try to incorporate cooked tomatoes that are cooked with olive oil, which has also been shown to be beneficial, and cruciferous vegetables (like broccoli and cauliflower) into many of your weekly meals. Soy and green tea are also potential dietary components that may be helpful.

Avoid smoking and drink alcohol in moderation.

Seek medical treatment for stress, high blood pressure, high cholesterol, and depression.

Avoid over-supplementation with megavitamins. Too many vitamins, especially folate, may fuel the cancer’s onset. The take-home point is to focus on getting a variety of vitamins and minerals from whole foods.

Relax and enjoy life. Reducing stress in the workplace and home will improve your health and lead to a longer, happier life.

Ejaculation Frequency And ED Drugs

An observational study showed that the use of PDE5 inhibitors (i.e. Viagra and Cialis) in men with erectile dysfunction (and no history of prostate cancer) was associated with a decreased incidence in the rate of prostate cancer (Asian J Androl. 2013;15:246-248).

The investigators from Scott & White Healthcare in Temple, Texas, hypothesized that men treated with PDE5 inhibitors might ejaculate more often than untreated men, which may have a protective effect against prostate cancer (JAMA.2004;291:1578-1586).

The U.S. Food and Drug Administration approved Cialis (tadalafil) in 2011 to treat the signs and symptoms of BPH, and for the treatment of BPH and ED when the conditions occur simultaneously.

In two clinical trials, men with BPH who took 5 milligrams (mg) of Cialis once daily experienced a statistically significant improvement in their symptoms of BPH compared to men who were treated with placebo.

In a third study, men who experienced both ED and BPH and who took 5mg of Cialis once daily had improvement in both their symptoms of BPH and in their ED compared to men who were treated with placebo. “BPH can have a big impact on a patient’s quality of life,” said Scott Monroe, director of the Division of Reproductive and Urologic Products in the FDA’s Center for Drug Evaluation and Research, in a release on the FDA’s website. “A large number of older men have symptoms of BPH. Cialis offers these men another treatment option, particularly those who also have ED, which is also common in older men.”

Talk to your doctor before taking medication to treat BPH or erectile dysfunction.

Taking ED Drugs Post-Prostatectomy

In another study, however, data was collected on 4,752 men who had undergone prostate cancer surgery. One quarter of these men were given a drug to treat erectile dysfunction, while the remaining three quarters of the men were not given an ED drug. At the end of the study, while most clinical parameters were roughly equivalent, the researchers noticed a decline in the recurrence rate for those who were treated with the ED drugs.

"The effects of sildenafil and other selective PDE5 inhibitors [the ED drugs] on the immune system, on autonomic nerve development as well as on angiogenesis, are conceivable causes of our findings,” the study’s authors wrote.

In other words, taking drugs designed to treat erectile dysfunction after prostate cancer surgery might help reduce the likelihood of the cancer returning.

What Can You Do To Reduce The Impact Of Prostate Cancer?

Every November, you can grow your moustache and use it to raise funds for men’s health through the Movember Movement — which supports prostate cancer research, among other men’s health initiatives. According to Movember’s website, prostate cancer rates will double in the next 15 years, so this is a worthy cause.

The Movember Movement aims to reduce the number of men dying prematurely by 25% by 2030. The goal of Movember is to “change the face of men's health.”

When did this start?

Movember “officially” started in Melbourne, Australia in 2004, when a group of friends decided to revive an old fashioned trend — the moustache. Thirty guys grew a moustache for 30 days, and when they realised how much fun it was, they started raising money the next year and the rest is history. In 2015, $17.5 Million was raised for the Movember Foundation in Canada alone. $16 million was raised in the U.S. that same year.

How do you get involved?

The first thing you need to do is register. Once on the Movember.com site, it’s up to you as to how you want to get involved. The International Man of Movember is chosen from 21 national winners all over the world to wear the crown. There’s also a Miss Movember and “Lame Mo” awards category. That said, you don’t have to grow a moustache to take part — especially if it’ll save you the embarrassment of sporting a light dusting of peach fuzz all month.

You can instead take the Move Challenge and get physically active. According to Movember, this challenge is whatever you make it. Run a race. Learn to rock climb. Work out in costume. Try something new, beat your own personal best, all while raising funds for men's health. You can sign up directly for that here (in the U.S.) and here (in Canada).

Where do the funds raised go?

About 80% of funds raised through the foundation around the world directly impact men’s health programs.

Their partners, along with Movember Foundation managed programs, ensure that donations support a broad range of innovative, world-class initiatives in the realm of prostate cancer research, among others. All funds distributed to men's health partners are restricted to use in Movember Foundation-approved programs. This means that no funds are used to cover any partners’ fundraising and promotional costs — 100% goes directly to delivering health initiatives.